Thomas H. Crook

The mini‐mental state examination: Normative study of an Italian random sample

We provide a set of normative data on the Mini‐Mental State Examination (MMSE) from a random sample of 906 normal, healthy subjects of both sexes, 20 to 79 years of age. Subjects were selected in six Italian cities and in the Republic of San Marino. Results show the significant influence of sociodemographic variables, such as age and education, on MMSE performance. We used Multiple Linear Regression Analyses to correct MMSE normative values for these demographic effects. The analyses allow us to specify cutoff scores for distinguishing “normal” performance from “borderline” and pathologic performance.

SEROTONIN, MEMORY, AND THE AGING BRAIN

Serotonin is widely distributed throughout the central nervous system and is implicated in a variety of neural functions such as pain, feeding, sleep, sexual behavior, cardiac regulation and cognition. This paper is concerned with the last of these. Abnormalities of the serotonergic nervous system are well documented in pathologic studies of Alzheimers disease and there is evidence suggesting that changes in this system occur in association with non-disease aging. Data on the role of serotonin in learning and memory and on the effects of aging on brain serotonin function are reviewed and discussed in relation to pharmacologic treatment strategies for the memory impairments associated with advancing age.

Assessment of memory complaint in age-associated memory impairment: the MAC-Q.

Few brief self-report memory questionnaires are available, and non has been well validated. We designed a brief questionnaire, the MAC-Q, to assess age-related memory decline. Validity and reliability of the MAC-Q were assessed in 232 subjects meeting diagnostic criteria for age-associated memory impairment (AAMI). Concurrent validity of the MAC-Q was supported by a significant correlation (r = .41, p < .001) with a lengthy, well-validated memory questionnaire. Multiple regression analysis indicated that memory test scores were significant predictors of MAC-Q scores. MAC-Q scores were not predicted by Hamilton Depression Scale scores, suggesting that memory complaint in AAMI is not related to affective status. Internal consistency and test-retest reliability of the MAC-Q were satisfactory. Our data support the validity and reliability of the MAC-Q, a new brief memory questionnaire. The MAC-Q is of particular relevance to the assessment of AAMI, but should also prove useful in any clinical or research setting requiring a brief index of memory complaint.

Glutamate : its role in learning, memory, and the aging brain

Abstractl-Glutamate is the most abundant of a group of endogenous amino acids in the mammalian central nervous system which presumably function as excitatory neurotransmitters and under abnormal conditions may behave as neurotoxins. As neurotransmitters, these compounds are thought to play an important role in functions of learning and memory. As neurotoxins, they are believed to be involved in the pathogenesis of a variety of neurodegenerative disorders in which cognition is impaired. Moreover, brain structures which are considered anatomical substrata for learning and memory may be particularly vulnerable to the neurotoxic actions of these excitatory amino acids, especially in the elderly who are also the segment of the population most susceptible to impairments of mnemonic function. This paper is a review of data concerning the role of excitatory amino acids in the processes of learning and memory and in the pathogenesis and treatment of disorders thereof.

Estimated Prevalence of Age-Associated Memory Impairment Derived From Standardized Tests of Memory Function

Recent research on the prevalence of age-associated memory impairment (AAMI) has reflected considerable variability, with estimates ranging from 35% to 98%. This variability is attributed to (a) failure to employ the complete diagnostic criteria for AAMI and (b) failure to consider age as a variable in estimating prevalence. Analysis of published normative data on both standard clinical memory tests and computer-simulated everyday memory tests shows a clear increase in the percentage of persons meeting the AAMI memory performance criterion as a function of age. These data are offered as an upper-bound estimate of the prevalence of AAMI, by age decade.

Everyday memory performance across the life span: effects of age and noncognitive individual differences.

Gerontologists have long been concerned with the impact of individual-difference factors on memory. This study used a large sample (N = 2,495) of adult volunteers aged 18 to 90 years to determine if a set of individual-difference variables--vocabulary, education, depression, gender, marital status, and employment status--mediates the effects of aging on a wide range of laboratory-analogue tests of everyday memory. The data indicated that age was consistently the most significant predictor of memory performance, followed by vocabulary and gender. Vocabulary totally mediated age effects on a prose memory measure, and partial mediation of aging effects--primarily by vocabulary and gender--was observed on 5 other memory tests. These data suggest that when health samples of volunteers serve as research subjects, these individual differences can affect some memory test scores, but age remains the best overall predictor of memory performance.

Factors Attenuating the Validity of the Geriatric Depression Scale in a Dementia Population

The validity of the Geriatric Depression Scale (GDS) in cognitively impaired patients has been questioned. We investigated possible factors (memory loss, dementia severity, unawareness of illness) attenuating the validity of the GDS in patients with dementia.

A self-rating scale for evaluating memory in everyday life.

A memory self-rating scale is described that includes 21 ability-to-remember items, 24 items assessing frequency of occurrence of memory failures, and 4 global rating items assessing overall comparison to others, comparison to the best ones memory has ever been, speed of recall, and concern or worry over memory function. Factor analysis yielded 5 orthogonal Ability to Remember and 5 orthogonal Frequency of Occurrence factors. The factor structure was not affected by age or sex, and level of complaint on the factor scores was not strongly associated with age.

Implications of memory and language dysfunction in the naming deficit of senile dementia

Young normals, elderly normals, and patients with either mild-to-moderate or severe senile dementia of the Alzheimer type (SDAT) were administered several tests of language function and remote memory. On all of the language tests examined, elderly normals exhibited a mild, nonsignificant performance decrement relative to the young normals. Advanced SDAT patients were markedly impaired on all of the tests. Early dementia patients were most impaired, relative to aged normals, on tests of object naming, category instance fluency, and remote memory. The deficit was smaller on the WAIS vocabulary subtest, on selecting the name of a visually presented object, and on recalling the function of an object. Early SDAT patients were least impaired in selecting the picture of an object after its name had been provided and in selecting objects that belong to a specified functional category. The results are consistent with the notion that the language dysfunction in early SDAT is due to a deficit in semantic memory function in which general, categorical information remains available whereas information about specific attributes becomes less accessible. The object naming test might be useful in the assessment of treatment effects upon SDAT because of its sensitivity and specificity to dementia, its high face validity, and its independence of recent memory.

Parent-child relationships and adult depression.

Reports of early parental behavior provided by 714 hospitalized depressed patients were compared with those provided by 387 normal adults. The 2 groups were also compared on ratings of parental behavior along the acceptance-rejection and autonomy-control dimensions, based on reports of other informants. Differences between the groups suggest that depression in adult life may be related to parental rejection and control through techniques such as derision, negative evaluation, and withdrawal of affection during childhood. Maternal rejection was found more closely associated with depression in female than in male children, and the effect was essentially the same among black and white subjects. Paternal rejection, on the other hand, appeared more closely associated with depression in males than females among blacks, while among whites paternal rejection was related to depression in females rather than males. It is suggested that the thoughts of personal worthlessness and inferiority seen in depression and theorized by Beck to be of principal etiologic significance in the disorder may have their origin in the early parent-child relationships.